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William Pierce

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The Role of Science and Politics in Public Policy Decision Making

Posted: 08/03/2012 6:07 pm

Back in February, Alec MacGillis wrote an excellent piece for The Washington Post's Outlook section titled "Everything Is Political," in which he argued that it's okay for politics to be involved in our national policy-making.

At a time in which it seems that someone's always complaining that a decision was "political," his view was a refreshing one. And it helped to highlight an important question -- how should science and politics interact in public policy decision-making?

One of the examples he used to demonstrate his point was the controversy regarding the administration's decision that girls under 18 be required to get a prescription to buy Plan B, commonly known as the "morning-after pill." Proponents of making the Plan B drug available over the counter said that the science showed the drug to be effective and safe enough to purchase without a prescription off the drugstore shelf. But the administration took another view. They believed that while it may be safe and effective, they also asked whether it was good policy to make it available to girls 18 years of age and under without a prescription. Was this something our society was comfortable doing?

The central question was: Should science triumph all other considerations? Or should it be one of the factors considered when making decisions?

As a spokesman for the Department of Health and Human Services from 2001 to 2005, I was involved in this question when the Bush administration began to appoint new members to the various advisory committees within HHS and its agencies. Almost immediately we were charged with "politicizing science."

After eight years of a Democratic administration Republicans controlled the executive branch and all that went with it, including the appointment of members of hundreds of advisory committees. The Clinton administration had made its own appointments when it controlled government, as did the George H.W. Bush Administration previous to that and so on. What the issue was that some of the people we appointed had different points of view than the existing members of the various committees (whose terms were expiring, thus the new appointments).

If you don't think there are different points of view within the science community, all you need to do is attend a scientific conference. It is definitely a full-contact sport. And second, and most importantly, if you don't think there are competing views in science you don't understand the scientific process.

In one of science's most famous and important works, "The Structure of Scientific Revolutions," Thomas Kuhn posited that scientific advance is not characterized by inevitable evolution, but rather by "paradigm shifts" that occur when the foundations of "normal science" are challenged and undergo intellectual violence. Since then, while Kuhn's idea has been debated as to whether paradigm shifts are limited to just major advances or are more universal, his basic theory has taken hold.

Science is not a smooth process where everyone arrives at universal agreement. Instead, it is a competitive, intellectual battle. Not all people of science think alike; in fact, advancement happens when ideas bang into one another as Kuhn described.

Several examples in today's headlines demonstrate this point:

Vaccines: While demonstrated to be one of the great public health advances in the last 100 years, the safety and usefulness of vaccines were challenged by some in the late 1990s. In 1998 Andrew Wakefield, unscrupulously as we now know, ran an experiment to test a concern that the MMR vaccine caused autism. When his results were published in The Lancet, a firestorm of controversy followed. Families with autistic children were looking for an answer as to why their children had been afflicted with this syndrome, and Wakefield provided a possible answer. Particularly in the U.K. and to some degree in the United States, vaccine rates declined, leaving children vulnerable to previously unknown disease. What caused the controversy was that politics (politicians) intervened, giving credibility to the claim, which distorted the scientific process, delaying for years what should have taken only a short time to resolve. Eventually Wakefield's claim was demonstrated to be false. But the damage had been done, inoculation rates in the U.K fell and are still below what public health officials believe most effective for population protection. And there is now a permanent movement to reject the idea of the value of vaccinations.

BPA: BPA has been a chemical used in the manufacturing of plastics for more than 50 years. It is used to make products rigid and strong. Thousands of studies have been performed demonstrating its safety in levels humans are exposed to. These studies have been dominated by toxicologists. Recently, however, endocrinologists have begun to study BPA using different measures and outcomes to judge its safety. Their initial claims suggest BPA may not be as safe as claimed for the last 50 years. This is a clear example of Kuhn's theory in practice -- a competing idea has risen out of the academy to challenge the existing position. Unfortunately, instead of letting the scientific community hash it out, political advocacy has intervened as a means to push a specific agenda. But the good news is that so far, the scientific community, led by the FDA, has resisted the position of the advocacy community. The question is will they allow the scientific community, and can it, work its will. This is unclear.

Climate Change: The overwhelming scientific consensus is that our earth is going through a period of climate change, causing swings in weather conditions and temperatures. The question is whether this is the result of man-made causes or Mother Nature, since we know the weather has gone through great periods of weather change before. Politics has so perverted the climate change debate that it is difficult to understand it. However, because literally billions of dollars are at stake politics clearly has a role, but it seems the role is not to stop action but to direct it.

So how should science and politics interact in public policy making? Our evolving history of politics and advocacy points to a difficult path ahead.

Clearly, when scientific information and conclusions are central to public policy matters, it must be included in the decision making process. In many cases, it must be the dominant factor, such as in decision making by the FDA regarding market entry for a new drug. Politics cannot win this battle. But even here, because it involves a risk-benefit balance, as no product is without some level of risk, the answer is never without critics.

With vaccines, the safety battle, while a victory for science, lingers and most troubling, the impact appears permanent -- lower rates of vaccination of previously nearly nonexistent diseases, of which we now see occasional outbreaks. In the case of BPA, the advocacy world has aggressively entered the debate, using the scientific debate itself to try and gain a policy-making advantage. The question is whether science will prevail or will advocacy force a decision that may or may not be correct. And in climate change, politics has caused inaction, while the problem goes on.

As long as our public politics involves itself in scientific debate and tries to use the unfinished debate for a specific policy advantage the role of science will itself be a debate. This is unfortunate and something Kuhn never imagined when he explained how progress in science happens.

Author's Note: As a consultant with APCO Worldwide, Inc. I have worked on issues regarding vaccine safety and the safety of BPA. These opinions are my own.

 

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Back in February, Alec MacGillis wrote an excellent piece for The Washington Post's Outlook section titled "Everything Is Political," in which he argued that it's okay for politics to be involved in o...
Back in February, Alec MacGillis wrote an excellent piece for The Washington Post's Outlook section titled "Everything Is Political," in which he argued that it's okay for politics to be involved in o...
 
 
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BOBinPS
Really?
07:48 PM on 08/05/2012
Of course science debates various findings. As you say, that IS science. But if science comes to a consensus that agent X at environmental concentration Y leeds to a significantly increased occurrence of condition Z, then it would be insane for policy to ignore the hazzard. How does that really differ from what private health insurance does? if you smoke, your policy costs more. If you are old, your policy costs more...etc. Individuals should have the choice to smoke, regardless of the costs to themselves. the policy problem comes when their exercise of individual liberty costs the general public. The same argument applies to alcohol and many other human activities. Those that scream the most about lost liberties are those who lose the ability to limit the liberties of others. Abortion, contraception, same sex marriage affect only those who engage in those activities. Science is not the problem. The problem is anti-science.
07:10 PM on 08/05/2012
While the intermingling of science and politics is often regrettable, I sadly fear that as long as the profit factor remains, the spin doctor is in.
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MassWG
02:44 PM on 08/05/2012
Maybe the more important question is not about the absolute or relative role of science in policy questions, but about whether the supposed good of the collective trumps individual liberty. Once the majority of healthcare costs are borne by the public, or once any and all carbon emissions are considered "pollution", what is to stop policy makers from regulating any and all individual behaviors that they deem may carry a potential public cost? Does the individual still have the right of self-determination, or is his mere existence considered a potential violation not just of another individual's rights, but of the rights of the collective? Putting the good of the collective above individual freedom is the path to tyranny.
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
08:31 AM on 08/05/2012
One of only a few problems with this article is that medical science and physiology actually speaks louder on this issue in favour of the Walker-Smith / Wakefield research.

The team of researchers that undertook the Lancet study on ASD children with GI issues, of which Andrew Wakefield was only one, pioneered work that unfortunately only now is being recognised for its validity.

In the following five areas new discoveries in ASD pathology and etiology have underlined that foundational work.

1. Immune system dysfunction in ASD children

2. Biomarkers of Inflammation in Gut and Brain

3. Around 35% clinical regression in Autism

4. The importance of immune signalling pathways

5. The importance of the gut and it's differences in ASD chidren.

Add to this a prevalence of epilepsy in ASD children running at some 35 - 50 % and the picture becomes indeed slightly more complex.

Even the 'independent' researchers confirm that children with ASD and GI issues have 87 - 88% clinically confirmed regression.
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
10:00 AM on 08/05/2012
I suppose if I was to talk science then it would be requisite for me to link science research....

1. http://www.ncbi.nlm.nih.gov/pubmed/22802640

http://www.ncbi.nlm.nih.gov/pubmed/22760919

2. http://www.ncbi.nlm.nih.gov/pubmed/22747567

3. http://www.ncbi.nlm.nih.gov/pubmed/22855372

4 http://www.ncbi.nlm.nih.gov/pubmed/21935439

5 http://www.ncbi.nlm.nih.gov/pubmed/21810417

...amongst many research studies.

... it has taken 14 years for this overwhelming evidence to be recognised and begun to be translated into real treatment therapies. It took to 2010 for a 'Consensus Statement" on GI issues to be made and even now there are voices that try to distract from real physiological issues.

If science had been the focus rather than politics ...
07:48 PM on 08/03/2012
This is an old argument, that "science" is all about conflicting ideas and that the possibility of many viewpoints exists. While technically true, this is an oversimplification. The same argument is given to say that intelligent design is just as scientifically fit a theory as the big bang and evolution are. It's a very false argument. Yes, science is about ideas going head to head, but some ideas lose that battle and are no longer acceptable. It's no longer acceptable to deny evolution (this has life and death consequences...look at the evolution of super-viruses). It shouldn't be acceptable to deny climate-change either, but somehow it still is.

Unfortunately, science can be cherry-picked like intelligence was before the Iraq war. It's easy to give misleading snapshots while ignoring the larger picture that is against your argument. People shouldn't stand for it.

Politics is a bad thing in science. Plenty of parties have an interest in skewing objective science towards expedient conclusions. We've known about climate change for years, but we've done precious little. If the US had made a serious and concerted effort to ramp up alternative energy in the 90s, think where we could have been by now. We could have advanced the technology, lowered the cost, and could all be enjoying cheap, domestically produced energy that's environmentally responsible by now. But it was politically and economically expedient to ignore the warnings. Now half the US is a disaster area.